Dalbeth, NicolaStewart, SarahGamble, Gregory DMihov, BorislavStamp, Lisa KHaslett, JanineTaylor, William JMerriman, Tony RTabi-Amponsah, Adwoa DansoaHorne, AnneNeogi, TuhinaPascart, TristanAndrés, MarianoPeral-Garrido, Maria-LuisaNorkuviene, EleonoraMellado, Janitzia VazquezUhlig, TillSun, MingshuLi, ChangguiPetrie, Keith J2025-09-032025-09-032025-08-29Arthritis Care and Research, ISSN: 2151-464X (Print); 2151-4658 (Online), Wiley. doi: 10.1002/acr.256392151-464X2151-4658http://hdl.handle.net/10292/19751BACKGROUND/AIMS: Asymptomatic hyperuricemia is a precursor of gout and is also associated with cardiovascular disease and chronic kidney disease. The aim of this study was to understand perceptions about asymptomatic hyperuricemia and views about urate-lowering therapy in people with asymptomatic hyperuricemia. METHODS: Participants in a multi-national study of asymptomatic hyperuricemia completed questionnaires about their perceptions of hyperuricemia, concern about hyperuricemia-associated health conditions, and willingness to take urate-lowering medication. All had a screening serum urate of ≥0.48 mmol/L (8 mg/dL) and no current or previous symptoms of gout. RESULTS: Overall, participants perceived that hyperuricemia had no or very few consequences on their life. Dietary factors were the most reported cause, while 37% did not know the cause. Participants reported a wide range in concern about hyperuricemia and the risk of developing gout. Concern about the risk of developing kidney disease or cardiovascular disease was also highly variable but was higher than concern about elevated serum urate (P<0.001). Most did not think a urate-lowering medication was necessary and there was moderate concern about the long-term use of urate-lowering medication. Medication necessity beliefs were most strongly associated with whether participants were willing to take urate-lowering medication (partial R2 =0.27, P<0.001). CONCLUSIONS: Most participants perceived minimal consequences of asymptomatic hyperuricemia. Hyperuricemia was not well understood by participants, and biological causes were generally under-recognised. Despite a range of concerns about hyperuricemia-associated conditions, particularly kidney disease and cardiovascular disease, a urate-lowering medication for asymptomatic hyperuricemia was not considered necessary, which aligns with most current management guidelines.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.http://creativecommons.org/licenses/by-nc-nd/4.0/1103 Clinical Sciences1117 Public Health and Health Services1701 Psychology3202 Clinical sciences4201 Allied health and rehabilitation scienceJournal ArticleOpenAccess10.1002/acr.25639